Proposed Nutrition Competencies for Medical Students and Physician TraineesA Consensus Statement

David M. Eisenberg, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Alexis Cole, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
Edward J. Maile, Sprink Ltd, Woodstock, United Kingdom.
Matthew Salt, Sprink Ltd, Woodstock, United Kingdom.
Elizabeth Armstrong, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Emily Broad Leib, Harvard Law School, Boston, Massachusetts.
Trevor Findley, Harvard Law School, Boston, Massachusetts.
Jennifer Massa, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Jaclyn Albin, University of Texas Southwestern, Dallas.
Meredith Alston, Intermountain Health/Saint Joseph Hospital, Denver, Colorado.
Hope Barkoukis, Case Western Reserve University, School of Medicine, Cleveland, Ohio.
Fred Buckhold, Saint Louis University, St Louis, Missouri.
Robert Danoff, Jefferson Health, Philadelphia, Pennsylvania.
Helen Delichatsios, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.
Stephen Devries, Gaples Institute, Deerfield, Illinois.
Stephanie Dewar, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Jennifer Di Rocco, University of Hawaii, Honolulu.
Christopher P. Duggan, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Kofi Essel, George Washington University School of Medicine & Health Sciences, Washington, DC.
Beth Frates, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.
Pamela Hansen, University of Utah, Salt Lake City.
Aviad Haramati, Georgetown University School of Medicine, Center for innovation and Leadership in Education (CENTILE), Washington, DC.
Timothy S. Harlan, George Washington University School of Medicine & Health Sciences, Washington, DC.
Michelle E. Hauser, Department of Surgery-General Surgery, Stanford University School of Medicine, Palo Alto, California.
David Leopold, Hackensack Meridian Health, Hackensack, New Jersey.
Joanna Lewis, Advocate Children's Hospital, Park Ridge, Illinois.
Amy Locke, University of Utah, Salt Lake City.
Joshua R. Mann, University of Mississippi Medical Center, Jackson.
Auden McClure, The Dartmouth Institute, Lebanon, New Hampshire.
John Wesley McWhorter, Suvida Healthcare, Houston, Texas.
Saroj Misra, A.T. Still University, Kirksville College of Osteopathic Medicine, Kirksville, Missouri.
Tiffany Murano, Columbia University, New York, New York.
Amy Oxentenko, Mayo Clinic-Rochester, Rochester, Minnesota.
Stacey Piercec-Talsma, University of New England College of Osteopathic Medicine, Biddeford, Maine.
Stacy Potts, UMass Chan Medical School, Worcester, Massachusetts.
Jo Marie Reilly, Keck School of Medicine of University of Southern California, Los Angeles.
Melinda Ring, Northwestern University, Chicago, Illinois.
Suzanne Sampang, Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Kate Shafto, Earl E. Bakken Center for Spirituality and Healing, University of Minnesota Medical School, Minneapolis.
Linda Shiue, Department of Adult and Family Medicine, Kaiser Permanente, San Francisco, California.
Wendelin Slusser, University of California, Los Angeles.
Terri Stone, Georgetown University Medical Center, Washington, DC.
Karen Studer, Loma Linda University, Loma Linda, California.
Olivia Thomas, Boston Medical Center, Boston, Massachusetts.
Jennifer Trilk, University of South Carolina School of Medicine Greenville, Greenville, South Carolina.
Laura Edgar, Accreditation Council for Graduate Medical Education, Chicago, Illinois.

Document Type

Article

Publication Title

JAMA Network Open

Abstract

Abstract

Importance: In 2022, the US House of Representatives passed a bipartisan resolution (House of Representatives Resolution 1118 at the 117th Congress [2021-2022]) calling for meaningful nutrition education for medical trainees. This was prompted by increasing health care spending attributed to the growing prevalence of nutrition-related diseases and the substantial federal funding via Medicare that supports graduate medical education. In March 2023, medical education professional organizations agreed to identify nutrition competencies for medical education.

Objective: To recommend nutrition competencies for inclusion in medical education to improve patient and population health.

Evidence review: The research team conducted a rapid literature review to identify existing nutrition-related competencies published between July 2013 and July 2023. Additional competencies were identified from learning objectives in selected nutrition, culinary medicine, and teaching kitchen curricula; dietetic core competencies; and research team-generated de novo competencies. An expert panel of 22 nutrition subject matter experts and 15 residency program directors participated in a modified Delphi process and completed 4 rounds of voting to reach consensus on recommended nutrition competencies, the level of medical education at which they should be included, and recommendations for monitoring implementation and evaluation of these competencies.

Findings: A total of 15 articles met inclusion criteria for competency extraction and yielded 187 competencies. Through review of gray literature and other sources, researchers identified 167 additional competencies for a total of 354 competencies. These competencies were compiled and refined prior to voting. After 4 rounds of voting, 36 competencies were identified for recommendation: 30 at both undergraduate and graduate levels, 2 at the undergraduate level only, and 4 at the graduate level only. Competencies fell into the following nutrition-related themes: foundational nutrition knowledge, assessment and diagnosis, communication skills, public health, collaborative support and treatment for specific conditions, and indications for referral. A total of 36 panelists (97%) recommended nutrition competencies be assessed as part of licensing and board certification examinations.

Conclusions and relevance: These competencies represent a US-based effort to use a modified Delphi process to establish consensus on nutrition competencies for medical students and physician trainees. These competencies will require an iterative process of institutional prioritization, refinement, and inclusion in current and future educational curricula as well as licensure and certification examinations.

DOI

10.1001/jamanetworkopen.2024.35425

Publication Date

9-2024

Comments

Eisenberg DM, Cole A, Maile EJ, et al. Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement. JAMA Netw Open. 2024;7(9):e2435425. doi:10.1001/jamanetworkopen.2024.35425

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